Objective To explore the effect of nutritional status of vitamin A and E on maternal and fetal outcomes during pregnancy. Methods The clinical data on a total of 4788 pregnant women under regular prenatal examination was collected in the obstetric clinic of our hospital. 10289 serum samples were collected at T₁ (≤ 12 weeks), T₂ (24-28 weeks) and T₃ (≥ 32 weeks) in the early stage of pregnancy. The concentrations of serum vitamin A and E were determined quantitatively by HPLC. The nutritional status of vitamin A and E during pregnancy was analyzed to study the effect of abnormal vitamin A and E on pregnancy outcomes. Results The overall nutritional status of vitamin A in pregnant women was good. 94.14% of these pregnant women had appropriate levels of vitamin A, 5.17% had vitamin A deficiency and 0.69% had excessive vitamin A. Vitamin A deficiency was the main abnormality during pregnancy. The rate of vitamin A deficiency in the third trimester (9.79%) was significantly higher than in the first trimester (5.74%) and the second trimester (2.31%).The incidence of gestational diabetes, anemia, premature delivery and low birth weight was significantly higher among pregnant women with vitamin A deficiency than among pregnant women with normal levels of vitamin A, and the difference was statistically significant (P<0.05). The overall nutritional status of vitamin E during pregnancy was good. 94.38% of these pregnant women had appropriate vitamin E levels, 0.12% had vitamin E deficiency and 5.50% had excessive vitamin E. Excessive vitamin E during pregnancy was the leading abnormality. The excess rate of vitamin E in the third trimester (20.18%) was significantly higher than in the first trimester (0.34%) and the second trimester (4.75%). The difference was statistically significant (P<0.05). The incidence of gestational diabetes mellitus among pregnant women with excessive vitamin E was significantly higher than among those with normal levels of vitamin E (P<0.05). Conclusions The monitoring of vitamin A and E levels should be strengthened during pregnancy and adjusted to an appropriate level in time to reduce the adverse effects on maternal and fetal outcomes.